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CSO Enrolment FormPlease fill in ALL the sections below and return the form to studentsupport@deafsociety.com or post to the Deaf Society, 4/69 Phillip Street, Parramatta NSW 2150. If you have any questions, contact us on 02 8833 3600.

SECTION 1: COURSE DETAILS Tick the course would you like to enrol in.

Please note: these courses are offered for Semester 1, 2018

This training is subsided by the NSW Government.

Course code Course Name Location Duration Please Tick

22075VIC Certificate II in Auslan Parramatta 19 Weeks ☐

22235VIC Certificate I in General Education for Adults

(Introductory) Computer Skills

Parramatta 19 Weeks ☐

22234VIC Course in Initial General

Education for Adults Maths & Money

Parramatta 19 Weeks ☐

22235VIC Certificate I in General Education for Adults

(Introductory) Technology Skills

Parramatta 19 Weeks ☐

22234VIC Course in Initial General

Education for Adults Reading and Writing

Parramatta 19 Weeks ☐

FSK10113 Certificate I in Access to

Vocational Pathways Communication and

Problem Solving Skills

Parramatta 19 Weeks ☐

* If you have previously studied Auslan elsewhere, please provide the Deaf Society with a copy of any Certificates or Statements of Attainment. Please note that there is a new training package for the 22075VIC Certificate II in Auslan currently pending approval which may be available for semester 1, 2018. Should you enrol in 22075VIC Certificate II in Auslan, the Deaf Society will notify you of any changes to your enrolment and request confirmation of your intention to continue with the new program.

SECTION 2: UNITS OF COMPETENCY

22075VIC Certificate II in Auslan Course Code Course Name VU20230 Use simple Auslan for personal purposes VU20229 Use simple Auslan for learning purposes VU20231 Use simple Auslan for social and community purposes VU20228 Use simple Auslan for employment purposes VU20232 Outline the development of social and educational conditions for deaf communities VU20234 Identify significant features of deaf community and culture VU20233 Apply basic principles of learning Auslan as a second language

22235VIC Certificate I in General Education for Adults (Introductory) Computer Skills Course Code Course Name VU21305 Create simple texts for employment purposes BSBITU101 Operate a personal computer VU21315 Access the internet for language learning

22234VIC Course in Initial General Education for Adults Maths & Money Course Code Course Name VU21291 Recognise numbers and money in simple, highly familiar situations VU21295 Recognise and locate simple numerical information in short, simple highly familiar texts

22235VIC Certificate I in General Education for Adults (Introductory) Technology Skills Course Code Course Name VU21314 Apply basic computer skills to language learning VU21315 Access the internet for language learning BSBITU101 Operate a personal computer

22234VIC Course in Initial General Education for Adults Reading and Writing Course Code Course Name VU21284 Engage with short simple texts for learning purposes VU21287 Create short simple texts for personal purposes VU21288 Create short simple texts for learning purposes

FSK10113 Certificate I in Access to Vocational Pathways Communication and Problem Solving Skills Course Code Course Name FSKOCM02 Engage in basic spoken exchanges at work FSKRDG01 Recognise highly familiar workplace signs and symbols FSKWTG05 Complete simple workplace formatted texts FSKLRG04 Use basic strategies for work-related learning FSKLRG02 Identify strategies to respond to basic workplace problems

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SECTION 3: PERSONAL DETAILS

Title: (Please Tick) ☐ Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Other

Gender: (Please Tick) ☐ Male ☐ Female ☐ Other

*Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names.

Given Name(s) Last Name

Phone Numbers: Home Mobile

Email Address

Date of Birth Country of Birth City of Birth

Primary Street Address: (Please provide the address where you usually reside. This cannot be a PO Box.)

Unit Number Street Number Street Name

Suburb State Post Code

Postal Address: (If different from above)

Unit Number Street Number Street Name

Suburb State Post Code

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SECTION 4: UNIQUE STUDENT IDENTIFIER NUMBER

It is compulsory to have a Unique Student Identifier (USI). If you are unsure as to what this is and need more information, please visit: www.usi.gov.au .

From 1 January 2015, the Deaf Society can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a USI.

If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.au/create-your-USI/

Please note that if you would like to specify your gender as ‘other’ you will need to contact the USI office for assistance.

Unique Student Identifier (USI) Number:

SECTION 5: STATISTICAL DETAILS

The Federal Government requires all colleges to collect the following statistics to help with their educational planning. Information provided will be treated in the strictest confidence.

Language and Cultural Diversity:

Are you of Aboriginal or Torres Strait Islander origin? (For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes)

☐ No☐ Yes, Aboriginal☐ Yes, Torres Strait Islander

Do you speak a language other than English at home?

☐ No, English only☐ Yes, Auslan☐ Yes, Other - please specify

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SECTION 6: STATISTICAL DETAILS CONTINUED

Disability:

Do you consider yourself to have a disability, impairment or long-term condition?

☐ No☐ Yes - please specify below (you may tick more than one box)Please refer to the Disability Supplement for an explanation of the following disabilities

☐ Hearing/Deaf ☐ Physical ☐ Intellectual☐ Learning ☐ Mental Illness ☐ Acquired Brain Impairment☐ Vision ☐ Medical Condition☐ Other - please specify ______________________________

Schooling:

What is your highest completed school level?

If you are currently enrolled in secondary education, please tick the highest school level you have completed. For example, if you are currently in Year 10, the highest school level completed is year 9.

☐ Year 12 ☐ Year 11 ☐ Year 10☐ Year 9 ☐ Year 8 or lower ☐ Never Attended

Are you still attending secondary school?

☐ Yes ☐ No

Previous Qualifications Achieved

Have you successfully completed any of the following qualifications?

☐ No

☐ Certificate III or Trade Certificate☐ Certificate II☐ Certificate I

☐ Yes - please specify below (tick all that apply)

☐ Bachelor Degree or Higher Degree☐ Advanced Diploma or Associate Degree☐ Diploma (or Associate Diploma)☐ Certificate IV (or Advanced Certificate / Technician)☐ Other education (including certificates or overseas qualifications not listed above)

Employment

Of the following categories, which BEST describes your current employment status? (Tick ONE box only) For casual, seasonal, contract and shift work, use the current number of hours worked per week todetermine whether full time (35 hours or more per week) or part-time employed (less than 35hours per week).

☐ Unemployed - seeking full-time work☐ Unemployed - seeking part-time work☐ Not employed - not seeking employment

☐ Full-time employee☐ Part-time employee☐ Self employed - not employing others☐ Self employed - employing others☐ Employed - unpaid worker in a family business

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SECTION 7: STATISTICAL DETAILS CONTINUED:

Study Reason

Of the following categories, which BEST describes your main reason for undertaking this course / traineeship / apprenticeship? (Tick ONE box only)

☐ to get a job ☐ I wanted extra skills for my job☐ to develop my existing business ☐ to get into another course of study☐ to try for a different career ☐ for personal interest or self-development☐ to get a better job or promotion ☐ other reasons☐ it was a requirement of my job

SECTION 8: RPL (RECOGNITION OF PRIOR LEARNING)/CREDIT TRANSFER

RPL and Credit Transfer is offered as a way of recognising work you have already completed. If you tick yes, we will contact you to discuss your options. If you are unsure or need more information, contact the Student Support Officer.

Do you wish to apply for RPL/Credit Transfer?

☐ Yes ☐ No

SECTION 9: COURSE FEES

This training is subsidised by the NSW Government. What you will actually pay depends on your individual circumstance. In order to assist us in calculating your correct course fee, please fill in this section and provide us with the required documentation.

If you would like more information, or would like to calculate your own fee visit: https://smartandskilled.nsw.gov.au/ .

I reside:

☐ I live or work in NSW (or I am an Aboriginal or Torres Strait Islander person living in specific NSW border areas)☐ I live in NSW social housing or am on the NSW Housing Register

My residence status is:

☐ Australian citizen☐ Australian permanent resident☐ Humanitarian visa holder or☐ New Zealand citizen

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SECTION 10: COURSE FEES CONTINUED

I am registered or intend to register in a traineeship for this qualification in NSW.

☐ Yes, registered (Please specify the type of traineeship, e.g. New Entrant Traineeship)☐ Yes, intending to be registered (Please specify the type of traineeship)☐ No

I am a student with a disability or am the dependent of a person with a disability.

☐ Yes (Please provide us with evidence of the benefit or disability. E.g. Medical Certificate, Disability Pension Card, Centrelinkevidence and state which type of card you have) ____________________________________________________☐ No

I receive government benefits.

☐ Yes (Please provide us with evidence. E.g. Pension or Health Care Card and state which type of card you have below. ForFamily Tax Benefit, you must be receiving maximum rate for Part A)_________________________________________☐ No

I am an Employment Service Provider client.

☐ Yes, (Please provide Employment Service Provider Organisation/ID and Client ID)☐ No

I am long term unemployed.

☐ Yes, (Please provide us with evidence. E.g. Current Commonwealth Benefits card)☐ No

For students who aren’t eligible for subsidised funding, the Deaf Society will determine the price for the qualification to be undertaken according to class numbers, location of students and course availability. Students are required to contact the Student Support Officer to obtain a qualification price in writing, prior to submitting their enrolment form.

SECTION 11: PROOFS

In order to proceed with enrolment, you need to provide the Deaf Society with a copy of one of the proofs from each of the categories listed below.

Proof of ID

I have attached proof of my citizenship in the form of one of the following: ☐ Yes ☐ No

☐ Australian or New Zealand birth certificate☐ Australian or New Zealand Passport (resident for more than six (6) months)☐ Green Medicare card☐ Naturalisation Certificate☐ Humanitarian VISA☐ Certificate of Evidence of Resident Status (Permanent Resident)

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SECTION 12: PROOFS CONTINUED

Proof of NSW residency or employment

I have attached proof of my residency or employment in the form of one of the following:

☐ Yes ☐ No

☐ Current NSW driver’s license☐ Health Care card or Pension card☐ Proof of Age card☐ Letter or email from NSW employer to show the street address where you areworking☐ Utilities account relating to your NSW address within last 3 months of rentaldocument

Proof of Disability (if applied)

I have attached proof of my disability in the form of one of the following: ☐ Yes ☐ No

☐ Letter from a medical practitioner☐ Letter from appropriate government agency☐ Letter from TAFE NSW Teacher/Consultant for students with a disability☐ Letter from special education coordinator☐ Letter from specialist allied health professional☐ Disability pension card

SECTION 13: FEES & REFUNDS

The Deaf Society provides students with information pertaining to fees and refunds prior to enrolment in order to ensure that students are aware of the costs associated with undertaking training as well as their obligations.

Upon submitting the Enrolment Form students will pay a non-refundable administration fee of $80. A payment plan can be found on the last page of this form. Students may also negotiate their own payment plan for the remainder of the course fees, to be paid over the duration of the course.

For students who receive RPL or Credit Transfer for any Units(s) of Competency, the course fee will be adjusted according to the Fee Administration Policy of the relevant Government Funding Body.

The Deaf Society will not accept enrolments without the payment of the administration fee, as listed on the Enrolment Form, unless they are fee exempt.

A Certificate or Statement of Attainment will only be issued upon completion of a course when all fees owed to the Deaf Society have been paid.

The Auslan Only Weekend (AOW) forms part of each course. The Deaf Society absorbs the cost of this weekend in order to provide students with a full Auslan immersion opportunity. Attendance at the AOW is a requirement of the course. If a student cannot attend, they will need to inform the Deaf Society, in writing, at least three weeks prior to the start date of the AOW. If notice of withdrawal is given with less than three weeks’ notice, students will be charged a cancellation fee of $150.

A student is eligible for a fee concession (where advertised) if, at the commencement of training, they hold a current and valid:

• Australian Government Health Care Card; or• Australian Government Low Income Health Care Card; or• Australian Government Pensioner Concession Card; or• Department of Veteran’s Affairs (DVA) Health Card (Gold)

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SECTION 14: FEES & REFUNDS CONTINUED

The Deaf Society can only waive or grant a fee concession for a student where evidence of genuine hardship is proved or where one of the above listed forms of evidence is obtained from the student prior to the finalisation of the enrolment process.

Refunds are given under the following conditions:

• A full refund will be given if the DS cancels a course.• A student who withdraws within 7 days of the first face-to-face class will receive a refund, less the $80

administration fee.• No refunds are available after the commencement of the course.• A student who enters into a payment plan and then withdraws from the course will be liable to pay the

enrolment fee or full fee for the course. Payments will fall due as per the payment plan.• A student who successfully applies for a funded place and withdraws after applications have closed will have

to pay the $80 administration fee.• If an enrolled student indicates that they wish to defer, the Deaf Society will make every effort to assist the

student to continue training where possible. If the student proceeds with the deferral, the Deaf Society canonly permit a deferral or deferrals totalling no more than 12 months from the date of receipt of notice from thestudent. The Deaf Society will advise students of the fee implications of deferring their Subsidised Training inaccordance with the Fee Administration Policy set out by the relevant Government Funding Body.

If a student wishes to claim a refund, the student will need to submit a request to the Executive Manager, Education Services. The Executive Manager will either approve or decline the refund.

All fees and charges must be paid by the due date. Failure to pay fees and charges may result in any or all of the following until the student pays the full amount owed:

• Suspension from attending or participating in the course• Exclusion from assessment activities• Withholding of certification documentation• Termination of enrolment• Exclusion from any future enrolments at the Deaf Society

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SECTION 15: COMPLAINTS & APPEALS

The Deaf Society takes complaints very seriously and has a complaints policy to help manage and respond to allegations involving the conduct of:

• trainers, assessors and other Education Services staff• a student undertaking study with the Deaf Society

A complaint can be defined as anything that a student thinks is unfair or that makes them unhappy with Deaf Society services and which is not fixed by giving feedback to a staff member or manager. Complaints can be made about policies, facilities, services, staff members or other students.

The Deaf Society’s Student Complaints Policy outlines the process for lodging a complaint and can be found in the Student Handbook.

To meet the requirements of the Australian Skills Quality Authority (ASQA) Standards for Registered Training Organisations (RTOs) 2015, the Deaf Society has an appeals policy to manage requests for a review of decisions, including assessment decisions. Students have the right to challenge an assessment decision and to have a decision reviewed objectively by the Deaf Society, if:

• They believe that the outcome was unfair.• They believe that the process was unfair.• They were not informed, in advance, of the assessment criteria for the course.• The assessment criteria used for the assessment differs significantly from those proposed to, and agreed by,

the student.• The student objects, on legitimate grounds, to a member of the assessing panel.• The assessment environment adversely affects the student’s performance.• The student does not agree with the results of the assessment.

More detailed information on how to lodge an appeal can be found by reading our Assessment Appeal Policy in the Student Handbook.

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SECTION 16: PAYMENT DETAILS

Upon receipt of your enrolment form, the Deaf Society will debit the credit card below for the sum of $80.00 as the first payment for this course*. By returning this completed enrolment form to the Deaf Society, you understand that this fee is non-refundable. If you opt to withdraw from this course before the course begins, the sum of $80.00 will not be refunded to you.

*This fee may be waived if you are exempt from making payments for this course.

Upon receipt of my enrolment form, please debit my credit card the amount of $80.00 as the first instalment for this course. For remainder of the course, please debit my credit card according to the payment plan on page 13 of this enrolment form unless exempted or other options have been organised with the Deaf Society beforehand.

I am Paying by: ☐ Visa ☐ Master Card

Credit Card Number

Expiry Date

Card Holder’s Name Card Holder’s Signature

SECTION 17: EMERGENCY CONTACT

Emergency Contact Name of person to contact in an emergency _______________________________________________________

Relationship to you Contact Number _____________________

SECTION 18: PERMISSON

Permission to use photograph/videos I give permission for the Deaf Society to take my photo or film me during classes or at Deaf Society events. I also give permission for these photographs/videos to be used for Deaf Society marketing purposes, assessment purposes or for teacher moderation and assessment validation.

□ Yes □ No

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SECTION 19: PRIVACY STATEMENT & STUDENT DECLARATION Privacy NoticeUnder the Data Provision Requirements 2012, The Deaf Society is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by the Deaf Society for statistical, regulatory and research purposes. The Deaf Society may disclose your personal information for these purposes to third parties, including:• School – if you are a secondary student undertaking VET, including a school-based apprenticeship or• traineeship;• Employer – if you are enrolled in training paid by your employer;• Commonwealth and State or Territory government departments and authorised agencies;• NCVER;• Organisations conducting student surveys; and• Researchers.

Personal information disclosed to NCVER may be used or disclosed for the following purposes:• issuing statements of attainment or qualification, and populating authenticated VET transcripts;• facilitating statistics and research relating to education, including surveys;• understanding how the VET market operates, for policy, workforce planning and consumer• information; and• administering VET, including programme administration, regulation, monitoring and evaluation.You may receive an NCVER student survey which may be administered by an NCVER employee, agent orthird party contractor. You may opt out of the survey at the time of being contacted.NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published onNCVER’s website at www.ncver.edu.au). Student Declaration and ConsentI declare that the information I have provided to the best of my knowledge is true and correct.

I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.

The Deaf Society has a Privacy Statement (https://deafsocietynsw.org.au/documents/Privacy_Statement1.pdf ) which you can read for more information.in

The personal information the Deaf Society collects from you will be recorded and used for providing our services to you, including evaluating and planning our services.

I understand that I consent to the collection of my personal information by the Deaf Society, including information about any disability (if I choose to provide that information). I understand the information provided and agree to follow the policies in the Student Handbook. I understand that if I withdraw from the course I am still bound to pay the full fees as they fall due.

I acknowledge that I have been offered the opportunity for RPL/Credit Transfer and that I have been provided with information regarding the following: • Fees and refunds• Complaints and appeals• Course duration and location

If you need more information on any of the above, please contact the Student Support Officer before signing below.

Student signature: Date:

Parent/guardian signature: Date: *Parental/guardian consent is required for all students under the age of 18.

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SECTION 20: CONSENT

Consent to use and disclosure of personal information to the Department of Industry, Skills and Regional Development and other Government Agencies

I, (First, middle and last Name)

of (Current residential address)

Date of birth:

understand and agree that personal information (information or an opinion about me), collected from me, my parent or guardian, such as my name, Unique Student Identifier, date of birth, contact details, training outcomes and performance, or sensitive personal information (including my ethnicity or health information) (together Personal Information) collected by the Deaf Society may be disclosed to the Department of Industry, Skills and Regional Development of Industry, Skills and Regional Development (Department).

The Department may disclose my Personal Information to other Australian government agencies, including those located in States and Territories outside New South Wales. The above government agencies may use my Personal Information for any purpose relating to the exercise of their government functions, including but not limited to the evaluation and assessment of my training, the determination of my eligibility to receive subsidised training or for any Fee Exemptions or Concessions. My Personal Information may also be disclosed to other third parties if required by law. I consent to the collection, use and disclosure of my Personal Information in the manner outlined above. I also acknowledge and agree that the Department may contact me by telephone, email or post during or after I have ceased subsidised training with the Deaf Society for the purposes of evaluating and assessing my subsidised training.

Print full name: Date: _____________

Signature:

Note: If under 18 years of age at the time of giving consent, then the consent of their guardian is required.

Print full name of guardian:

Signature of guardian: Date: ____________

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SECTION 21: STUDENT NEEDS & EXPECTATIONS

This will be given to all of your trainers/assessors to help them cater the course to your needs.

Student Name: Date:

What do you think the course is about?

Office Use Only

Education Services has read and acknowledge the student’s needs and expectations above.

Any action needed: Yes No

If yes, please outline action needed:

DS Representative:

What do you hope to learn from this course?

How do you like to learn? (tick as many you want)

☐Work Alone☐Work in group☐Using technology such as computer, ipad, video, etc☐Practical activities

What do you think is the most important part of the course for you?

☐Reading☐Writing☐Maths☐Computers☐Learning about the workplace

How do you think this course will help you? (tick as many as you want)

☐Confidence☐Independent☐Improve communication☐Develop Job skills☐Learn new skills☐Improve self esteem☐Other

This document has been explained to me in Auslan by (write name of person here):

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Office Use Only • USI number provided? Yes � No � • Proof of ID provided? Yes � No � • Proof of NSW residency or employment? Yes � No � • Proof of disability if applicable? Yes � No � • Statistical information complete? Yes � No � • Smart and Skilled questions answered and proof provided? Yes � No � • Credit card details provided? Yes � No � • Privacy Statement & Student Declaration signed and dated? Yes � No � • Consent form completed? Yes � No � • Student needs and expectations completed? Yes � No � • Any relevant transcripts required and provided? Yes � No � • Completed the LLN test? Yes � No �